Appendix G2: SCBA Respirator Periodic Inspection and Maintenance

Date:_________________________________

Location: ____________________________

Respirator ID #:_______________________

Cylinder #:___________________________

Cylinder Pressure PSIG:______________

Note:

SCBA respirators must be inspected for defects after each use, and at least once monthly if it is not used. The equipment must be repaired as necessary, cleaned and disinfected, and then stored properly to assure that it is maintained in satisfactory working condition. A record must be kept of inspection dates and findings.

If any defects are found, DO NOT use the equipment until it has been repaired by an authorized technician. In many cases, repairs by a factory authorized service center may be necessary.
The manufacturer of the equipment must be contacted to obtain specific inspection and maintenance instructions. The manufacturer's instructions must be incorporated into this checklist or must be used to modify it.

General

Yes

On Order

Serviced

1) Is main or reserve air tank filled?

_______

_________

____________

2) Is unit clean?

______

_________

____________

3) Are all straps on the face piece and backpack fully extended, hooked up and in good condition?

_______

_________

____________

4) Case and Cover ; Free of dents or heat damage?

_______

_________

____________

5) Have air tanks been hydrostatically tested recently?
- Check the manufacturer's recommendation for frequency; standard steel cylinders must be tested and internally inspected every 3 years.

_______

_________

____________

Facepiece

Yes

On Order

Serviced

6) Face piece Lens

Is it without nicks, scratches, or abrasions which would impair outward visibility, or, deep gouges/ cracks which would reduce impact resistance?

_______

_________

____________

7) Head strap Buckles

Have crushed, bent, or corroded buckles been replaced?

_______

_________

____________

Have damaged, loosened rivets or other fasteners been repaired?

_______

_________

____________

8) Mask Rims

Are rim screws securely tightened?

_______

_________

____________

Have deformed broken rim pieces been replaced?

_______

_________

____________

9) Inlet Nozzle

If there is sticking evident while exhaling through the exhalation valve, has it been corrected?

_______

_________

____________

Check the following inlet devices:

Screws securing the nozzle

_______

_________

____________

Clamps securing the low pressure hose to the nozzle.

_______

_________

____________

Exhalation valve seat

_______

_________

____________

Damage to the nozzle body such as warping, or cracking.

_______

_________

____________

Nozzle spring.

_______

_________

____________

10) Face piece Skirt

Have sealing lips been checked for cuts, gouges, punctures, tears and nicks?

_______

_________

____________

Have materials that are hardening or deteriorating been checked?

_______

_________

____________

11) Convoluted Low Pressure Hose

Have cuts, nicks or punctures in the hose been repaired?

_______

_________

____________

Has rubber been checked for age or heat-induced cracking, crazing, or hardening?

_______

_________

____________

Are crushed, broken or cracked parts of quick connect repaired?

_______

_________

____________

12) Head strap Spider

Is abrasion or nicking of head strap legs repaired?

_______

_________

____________

Is there age or heat induced hardening of the rubber?

_______

_________

____________

Second Stage Regulator

Yes

On Order

Serviced

13) Valves

_______

_________

____________

Are both main and bypass valves operational?

_______

_________

____________

Does the one way quick connect valve assembly operate smoothly, if present?

_______

_________

____________

Is the main valve open, and the bypass valve closed?

_______

_________

____________

Is the selector lever, if present, in the "demand on " position?

_______

_________

____________

14) Pressure gauge

Is it operational? The lens is clear, pointer to zero, and there is no needle deformation.

_______

_________

____________

15) Hose and fittings; No damaged threads or worn out slots on quick connect adapter?

_______

_________

____________

16) Are the "O" rings in low pressure air outlet and other gaskets flexible?

_______

_________

____________

Audible Alarm, First Stage Regulator, and Intermediate Pressure hose

Yes

On Order

Serviced

17) The bell alarm works. Has debris or water under the bell or dents or deformation of bell been corrected?

_______

_________

____________

18) The hose and end connectors are in good condition. Has abrasion or damage to hose been repaired?

_______

_________

____________

19) Are retaining rings securely fastened to end connectors?

_______

_________

____________

20) The threads and fittings are in good condition.

_______

_________

____________

21) The "O" rings or other gaskets are flexible.>

_______

_________

____________

Backpack and Air Cylinder

Yes

On Order

Serviced

22) Backpack

Cylinder holder properly functions.

_______

_________

____________

Cylinder is secure in frame and band.

_______

_________

____________

Buckles, shoulder straps and waist belt stitching of webbing is in good condition.